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Matthew Miller, MD
Chief Medical Officer, WCHN

Danbury/New Milford Single License Integration: New Bylaws
Good progress, a hurdle, and lots of value

Well, we’ve been talking and planning for months about our two hospitals becoming a single license with a single Medical Staff. We’ve talked about the basic implications of that plan, with one Medical Executive Committee, one Chair per department, and one set of Bylaws. With that in mind, an integration committee of physician leaders from both Medical Staffs has been working for months on a brand new version---and it’s almost done.

But we do have a hurdle to overcome. The State has recently determined that our move to a single license will require a complete Certificate of Need application. We have started the CON application but, unfortunately, that delays our complete implementation to a single license for many months and thus delays our ability to officially put a new set of Bylaws in place.

Nevertheless, our new draft documents contain valuable ideas that need not be delayed, even if we have to keep certain functions separate. The new documents also reflect what we think are newer and better ways for us to govern ourselves and to continue our track record of attracting and maintaining a high quality Medical Staff at both our institutions.

Here is the plan:

  • The new draft Bylaws will be submitted and, after study, potentially approved at the August (DH) and September (NMH) Medical Executive Committees at both hospitals. There will be two versions. One for approval and “shelving” pending single license approval by the State and one (each) for DH and NMH respectively that maintains all the new improvements but separates critical functions (such as an independent MEC) at both hospitals.
  • Once approved, each Medical Staff will have several weeks to review and then to potentially approve at respective General Medical Staff meetings in September (DH) and October (NMH).
  • For Danbury, at least, the Board of Directors could approve DH Bylaws at its late September meeting.
  • Active Staff across the network will pick one campus as their primary site of practice, approved by the central MEC and Credentials Committee. Responsibilities will be balanced and no one will be expected to cover both hospitals. Nevertheless, physicians at one campus will be able to practice at the other campus as well, with some limits on inpatient activity but fewer restrictions on outpatient activity. Courtesy privileges will be solely available to physicians who have active staff privileges at another hospital in the Network-----for now implying NMH pending single license, for Norwalk in the future.
  • A “Nominating/Leadership Development Committee” will be formed that will play an important role going forward. It will identify candidates for Medical Staff officers, at large members of the MEC, appoint committee chairs and members, and take an active role in identifying and developing future leaders as part of its succession-planning responsibilities.
  • The Medical Executive Committee will be modified and streamlined, including representatives from both campuses. One consideration will be to proceed with that at Danbury, with NMH membership, even before single license is approved.
  • Expectations from (and support of) the entire Medical Staff are revised. Meeting attendance and CME tracking are simplified, but Medical Staff will have opportunities for greater education, some of which will be required.
  • Peer review functions will be enhanced, furthering the model of non-punitive but collaborative review of Medical Staff performance with respect to medical judgment, technical skill and professional conduct. Better links to root cause system issues rather than individual performance will improve the process.

Stay tuned! Once our MECs have reviewed and approved the draft documents, all of you will see the entire version, accompanied by a detailed description of changes. Our Integration Committee is comprised of: Matt Miller, Tom Koobatian, Bill Begg, John Mullen, Pat Tietjen, Evan Hack, Keith Zuccala, and Alphonse Altorelli.

Please contact me with any questions or suggestions.

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